When faced with even a modest health insurance co-payment for a mammogram, significantly fewer women receive these potentially life-saving breast cancer screenings, according to a new study by Brown University and Harvard Medical School researchers. The review included 366,475 women within 174 Medicare managed-care plans between the ages of 65 and 69 living in 38 states. The team compared the rates of biennial breast cancer screening within plans requiring co-payments with screening rates for plans with full coverage. They also analyzed data from plans that introduced co-payments over the three-year study period in order to study how mammography rates would change compared to rates in plans without co-payments.

Biennial breast cancer screening rates were eight to 11 percent lower in cost-sharing plans ??? a difference that persisted even when adjusting for possible differences due to income, education, race and other factors.

From 2002 to 2004, screening rates decreased by 6 percent in plans that introduced co-payments while screening rates increased by 3 percent in matched control plans that retained full coverage.